Author Topic: Billing 0100 for Residential Treatment RTC Substance Abuse procedure code  (Read 1037 times)

1UR1

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I normally bill substance abuse residential treatment with revenue code 1002 (1001 for mental health) with procedure code H0018 however I have been asked to bill with 0100. My question is, will there be a procedure code (HCPCS or CPT) required when billing with this revenue code? If so, what procedure code should be used? Would I still use H0018? Any help on the matter would be much appreciated.

EZlabor

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Re: Billing 0100 for Residential Treatment RTC Substance Abuse procedure code
« Reply #1 on: February 15, 2017, 11:23:44 AM »
I have the same issue. Lets go over together: I have 1001 and h0018 being denied. I see 0100 as all inclusive room and board while 1001 is more appropriate for services? I do not see another option. type of bill: 893. Rev code 1001. CPT H0018. This is for adolescent RES psych. So, type of bill 861
Did the carrier tell you to use 0100?
I have another company using 0124 But that is inpatient psych which would mean type of bill 111? and looks like its upcoming?
Any luck or suggestions?

Michele

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Re: Billing 0100 for Residential Treatment RTC Substance Abuse procedure code
« Reply #2 on: February 16, 2017, 09:01:32 AM »
Are you billing for room & board?  If so, there is no HCPCs or CPT to correspond.  Just put the description "room & board" and leave the HCPCs/CPT blank.
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1UR1

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Re: Billing 0100 for Residential Treatment RTC Substance Abuse procedure code
« Reply #3 on: February 16, 2017, 09:43:00 AM »
I am billing for Residential Treatment. The authorization we received was specifically for 0100 (UR is being done by the facility, I am just billing). Type of bill we are using is 113 (111 on the initial claim). I am sending claims with HCPCs/CPT blank. I will update this thread when I receive a response. Thank you.

EZlabor

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Re: Billing 0100 for Residential Treatment RTC Substance Abuse procedure code
« Reply #4 on: February 18, 2017, 02:55:05 PM »
Thanks. I am very curious to see how that works out. please do follow up.

 I show Residential as not being able to be used as 0100 since 111 and 113 are hospital? Unless you are providing residential services in a hospital? That may be upcoding?
  Residential services I was told-  are type of bill 861 and 862 with 1001 / HCPCS H0018 and 1002 / H0011 . It was my understanding that you cannot break out room and board on these services / this level of care? That it is all inclusive.

So, that all said- What are your thoughts / what do you find re: the above?